rominent among the challenges facing our profession is our ability to remain competitive as an academically and scientifically productive field of medicine. There are increasing concerns that academic anesthesiology — already underperforming other specialties in attracting support from the National Institutes of Health (NIH) — will be further weakened by an inability to attract and develop the next generation of researchers and clinician scientists.

For many academic anesthesiologists who aspire to a serious and sustained research career, their professional development has as its ultimate goal the attainment of significant independent funding from an NIH R01 award. These awards are extremely competitive, with an overall success rate for new applications across all agencies of only 16.3 percent in fiscal year 2006.

Given such marginal success rates, even the most solid research plan and compelling preliminary data are rarely sufficient to secure R01 funding. Applicants must demonstrate a strong background in research training and methodology and a demonstrated ability to successfully convert their research plans into academic productivity. Thus, investigators can rarely be competitive without the investment of several years of support, mentorship and training. In this domain, the NIH provides for a series of Career Development Awards (CDAs), such as the K08 and K23, aimed at the assistant professor level and designed to help investigators make the final push toward research independence through providing substantial protected academic time and a structured plan for obtaining training and mentorship.

If the NIH provides a pathway to independence from the assistant professor level, the challenge then is to provide a pathway for junior faculty to be competitive applicants for CDAs. The K-series awards are not starter grants and are intended for investigators who have already received a solid foundation of support and mentorship and who have demonstrated academic potential. It is during this earliest phase of career development that aspiring researchers are perhaps most vulnerable to fail.

FAER plays an instrumental role in supporting this vulnerable phase of career development, including in my own case. In 2004, I received a Research Starter Grant (RSG) from FAER. During the third (extension) year of that award, I applied for and was awarded a K08. Unquestionably, the conditions that provided for a successful K08 application would not have been possible without the FAER RSG.

At the core of the RSG was its provision of consistent and protected research time. In the earliest phase of career development, junior faculty usually face a circular challenge — a lack of demonstrated productivity makes it difficult to establish a legitimate claim on nonclinical time, but the absence of this protected time renders it virtually impossible to establish productive research. The RSG protected 40 percent of research efforts, and thus I was able to consistently dedicate two days per week to the planning, conduct and analysis of studies. Because the grant extended over two years, with a third-year extension, it provided sufficient longitudinal time to establish the studies methodically and rigorously and then to conduct an ambitious project.

Junior faculty also face a tremendous challenge in establishing sufficient credentials to warrant intramural financial support of their research. While it is expected that a junior investigator will utilize the equipment and facilities of his/her mentor and department, it is extremely difficult to develop a significant project without requiring additional funds. In my own case, this was especially true, as the proposed research incorporated several costly elements associated with fMRI and EEG experiments on human volunteers — much of which lay beyond any reasonable expectation of what could be provided intramurally to a junior investigator. The RSG provided $85,000, supporting the capability for the research to be conducted as conceived.

The RSG also carried several benefits extending beyond the specific project. It powerfully added legitimacy and standing to my academic efforts at a time when it was a challenge to establish credentials as a serious researcher. The FAER application process was far more manageable than its NIH counterpart, but it honed many grant writing principles that I was able to later apply to the K08. Finally, under the conditions provided by the RSG, I had a three-year immersion experience in the research process, which matured tremendously my understanding of the dynamics and challenges of a research career, the importance of the mentor-mentee relationship, and permitted me to be introduced to and to develop ongoing relationships with academic colleagues and peers.

The RSG, or any similar award, could not be successful without strong and sustained departmental support, and in this regard, I was extremely fortunate. However, even the most supportive department cannot offer a junior investigator the opportunities that were created for me by the RSG. If my own experience is an indicator of the power of the FAER grant program, then its maintenance and expansion must be of critical importance as we develop a strategy to address the challenges that threaten the academic arm of our profession.

Dr. Pryor’s talent and energy in a supportive environment allowed him to progress from a FAER RSG on to a K08 NIH award.

For many individuals and departments, the time and funding for an RSG was not sufficient to garner such success. The FAER Mentored Research Training Grant (MRTG) had in the past trained a higher percentage of investigators who went on to earn NIH funding. Hence, the decision was made to stop offering the RSG and to fund more MRTGs.

Kane O. Pryor, M.D., is Assistant Professor of Anesthesiology, Weill Cornell Medical College/Memorial Sloan-Kettering Cancer Center, New York, New York.

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